Taking Midwifery Pages

So you’re finally taking first call, congratulations. Now what? Clients don’t page just because their waters have broken or they think they’re in labour… they also page because their baby hasn’t peed all day or they fell down walking their dog.

What do you say? What your plan? How do you manage answering questions on the fly?

The simplest thing to do is to make a paging booklet with possible scenarios you might be paged for with flow charts and differential diagnoses with how to respond and create a care plan.

There are a few paging documents floating around the student body and they are an excellent place to start. I used one gifted to me by a senior student that helped me a lot. Writing my own was a lot of work but I feel incredibly prepared for any clinical scenario and will probably also use this as a great study tool.

Here’s how to make one:

  1. Start with some topics, here are a few from my booklet
    • Prenatal Bleeding
    • Cramping
    • Dizziness
    • Decreased Fetal Movement
    • Headache
    • Newborn CVS/CNS/MSK
    • Newborn Respiratory Issues
    • Newborn Infection
  2. Break up each topic into the following
    • Assessment
    • Considerations
    • Differential Diagnosis
    • Client Teaching
  3. Assessment
    • Questions that you need to ask the client
    • Think broadly and then narrow your search based on their responses
    • Questions should cover your differential diagnoses
    • E.g. client calls about bleeding, you ask them what they did today, they just had a stretch and sweep, is that normal?
  4. Considerations
    • What kind of things are important for you to remember in this topic’s context – Gestational age? Placental location? Drug use?
  5. Differential Diagnosis
    • Client is bleeding – think about all the reasons why
  6. Client Education
    • Usually includes physiology and instructions on when to page back
  7. DDX FOR ISSUE
    • On the next page, I have a chart with the all the possible issues
    • Columns are arranged in diagnosis, signs and symptoms, considerations, and management
    • When a client calls, you can run through the list and easily find your management plan
  8. Make a Table of Contents
  9. Save as a PDF
  10. Print in Booklet Format

Voila! You’re one step closer to feeling more comfortable being on call and you’ve studied a lot by writing this damn thing. You’re prepared to make a care plan, especially in the middle of the night when you have this document beside your phone.

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Some Resources to Consider:

  • SOGC ALARM Textbook
  • SOGC Guidelines
  • AOM Guidelines
  • AOM Emergency Skills Textbook
  • Comprehensive Midwifery Textbook
  • Pharmacotherapy Textbook
  • Neonatal Resuscitation Program Textbook
  • Canadian Paediatric Society Guidelines
  • Notes from your interprofessional clinical placements

Feel like you need even more prep? Write your own Midwifery Bible.

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